Maine Child Health Improvement Partnership (ME CHIP) Advisory Group Friday, February 9, 1-2 pm

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1 Maine Child Health Improvement Partnership (ME CHIP) Advisory Group Friday, February 9, 1-2 pm Webinar/Phone or phone ,,, #

Vision All practices providing health care to

opportunities for collaborative learning needed

2 Maine Child Health Improvement Partnership (ME CHIP) Mission To optimize the health of Maine children by initiating and supporting measurement-based efforts to enhance child health care by fostering public/private partnerships. Vision All practices providing health care to children will have the skills, support, and opportunities for collaborative learning needed to deliver high quality health care. ME CHIP is part of the National Improvement Partnership Network (NIPN)

3 ME CHIP Agenda 1:00 Welcome and Review of Dec. minutes 1:05 Discuss new Partnership for Children s Oral Health Partnership 1:35 Update on Project CALM-ADHD Project 1:40 Partner Updates/Opportunities for Alignment and Funding 1:55 Next Steps 2:00 Adjourn

4 Partnership for Children s Oral Health Becca Matusovich, Executive Director MECHIP Meeting - February

5 Partnershi p for Children s Oral Health A network of Maine organizations and individuals united by a shared mission: To eradicate dental disease in Maine children Goal: Catalyze collaborative action and innovation Initial multi-year funding committed by the Sadie and Harry Davis Foundation, additional investments will come from a range of sources

6 Current status of oral health among Maine children: improving, but more work remains Great progress has been made through From the First Tooth and other efforts, and more is still needed to ensure that all children have the tools for good oral health. The majority of children with MaineCare are not accessing preventive dental services regularly 4 out of 10 Maine children have cavities by 3 rd grade About 1/4 of Maine 3 rd graders have no sealants on any of their permanent molars Sources:

7 What will it take to ensure that all children can have the good oral health they deserve? Disease management methods Data tracking & trends over time Culture that promotes oral health Policies that impact oral health Navigation support roles Community Outreach & education Schoolbased Oral Health Programs From the First Tooth (& BTFT) Dental Homes

8 Initial work: 4 Action Teams forming in 2018 Partnership Council coordinates and provides collaborative leadership across the network How can we collectively reach more children with effective oral health services (prevention, disease management, treatment, restoration?) How can we make sure good data is available to inform policy and strategy design? Systems Innovation Data Systems Community Engagement & Culture Change Policy & Advocacy How can we build public understanding about oral health and engage people who experience the current system s gaps in designing solutions? What policies are needed and how can we foster collaboration to strengthen oral health policy?

9 Questions for discussion? 1. FTFT has made great strides over the past decade to build oral health and fluoride varnish application into well-child visits. What other systems-level changes do you think would have the most impact toward the mission of eradicating dental disease in Maine children? 2. Looking at the four buckets on the previous slide, are there things you already see happening that others need to know about? Who/what else is working that could/should be linked to broader efforts in these four areas? 3. Are there any discussions happening about links between oral health and childhood trauma/aces? Is anyone exploring needs for trauma-informed dental care, or addressing oral health needs within the context of addressing trauma more broadly? 4. What conversations are happening about supporting young adults in the transition from pediatric care to adult systems of care? How can we make sure that dental care is included in thinking about how to help young adults make the transition to taking ownership for their own care?

10 Interested in getting involved? Contact info: Becca Matusovich, Executive Director

Collaborative ADHD Learning in Maine Project Aim: To elevate the health of children by measurably improving the screening, diagnosis, and treatment for Attention Deficit and Hyperactivity Disorder

11 Collaborative ADHD Learning in Maine Project Aim: To elevate the health of children by measurably improving the screening, diagnosis, and treatment for Attention Deficit and Hyperactivity Disorder (ADHD). MQC is teaming up with the Maine Medical Education Trust and the Maine Chapter of the AAP to bring together up to 10 practice teams to work with school personnel and families in a yearlong learning collaborative to improve care and diagnosis for ADHD By July 2018, increase practice compliance up to 80% in the following domains for proper ADHD management: Improve proper ADHD Diagnosis and management so that patients are assessed for ADHD using a validated instrument across multiple major settings Parents of patients diagnosed with ADHD are given an educational ADHD Booklet Patients diagnosed with ADHD are prescribed behavior therapy

12 Partners Midcoast Pediatrics Winthrop Pediatrics EMMC Family Medicine Center and Residency Program SMHC Biddeford Pediatrics Dr. Harry E Davis Pediatric Center MMP South Portland Maine Parent Federation School Nurses and Health Staff Edmund Ervin Pediatric Center at MaineGeneral MMP Developmental Behavioral Pediatrics National AAP Team and 4 Sites in National AAP Project

13 CALM Schedule of Activities March 8 - Collaborative and Proactive Solutions for Children with Challenging Behavior: Lives in The Balance: Ross Greene, MD ADHD Developing two on demand online modules for QC Learning Lab Final Learning Session- April 13 th in conjunction with the MAAP meeting Data Collection

14 Friday, April 13, 2018 Maine AAP Conference with School Nurses & CALM Learning Session 8:00 am- Registration: Continental Breakfast, Exhibits and Poster Session Open 9:00 am- Welcome & Introductions Stephen Meister MD, MHSA, FAAP Medical Director, The Edmund N Ervin Pediatric Center MaineGeneral Medical Center President, Maine Chapter of the AAP Amy Belisle, MD, FAAP Medical Director, Maine Quality Counts Board Member, Maine Chapter of the AAP 9:05 am- Co-Managing ADHD between the Primary Care Office and Schools Deborah Hagler, MD, FAAP Pediatrician, MidCoast Hospital, Vice President, Maine Chapter of the AAP Carrie Woodcock Maine Parent Federation Linda Morris MSN, RN Lori Huot, RN 9:50 am- Managing ADHD in the Older Adolescent and at the College Level Bernie Hershberger, PhD Bowdoin College 11:00 AM - MORNING BREAKOUT SESSIONS How Providers can Assist Children with Special Needs get help in school: leps and 504s what are they and how are they different?- This session is for providers and other attendees not part of the CALM Learning Session. Jill Adams Maine Administrative Services for Children with Disabilities CALM Participant Session: Brainstorming on Spreading and Sustaining Change on ADHD work Throughout the Practice; Review QI Data and Progress- This session is for the CALM Learning Session Attendees only. Sue Butts- Dion Consultant to Maine Quality Counts

15 Friday, April 13, 2018 Maine AAP Conference with School Nurses & CALM Learning Session 12:30 pm- Understanding the connection between ACES, Resilience, and ADHD: Working More Effectively with Families Sue Mackey Andrews Maine Resilience Building Network Stephen J. Meister, MD, MHSA, FAAP MaineGeneral and Maine AAP 1:30 PM- AFTERNOON BREAKOUT SESSIONS The Maine Integrated Youth Health Survey 2017 Data Presented with Analysis- This session is for providers and other attendees not part of the CALM Learning Session Reid Plimpton Maine CDC Sheila Nelson, MSW, MPH Maine CDC CALM Learning Session: Practices Report: Share Seamlessly and Steal Shamelessly-This session is for the CALM Learning Session Attendees only. 2:45 pm- A New Prescription: Exercise and the Groundbreaking Techniques for the Treatment of ADHD, Aggression, and Autism Spectrum Disorder. John Ratey, MD Harvard Medical School 3:50- Wrap Up Kayla Cole Maine Quality Counts

16 Dr. John Ratey Keynote Speaker at April Learning Session

17 Partner Updates/Opportunities for Alignment

Data - Healthy Smiles 2020 Challenge Measurement Parameters Patient Panel: Number of children 6-48 months and have teeth Measure: Percent of patients ages 6 through 48 months, with teeth, seen in the

19 Data - Healthy Smiles 2020 Challenge Measurement Parameters Patient Panel: Number of children 6-48 months and have teeth Measure: Percent of patients ages 6 through 48 months, with teeth, seen in the measurement period with at least one documented fluoride varnish in the measurement period applied in the office or noted in EHR/other record keeping system - as completed outside of the medical home Numerator: Patients in the denominator with at least one fluoride varnish ages 6 through 48 months in the measurement period Denominator: Patients ages 6 through 48 months at the beginning of the measurement period, with teeth, with a visit to their PCP office within the measurement period. Source: Electronic Health Record or other record keeping system Annual Metric Challenge Goals: Metric Calendar Year baseline End of 2018 End of 2019 End of 2020 Percent of any office visit in target age group in which children receive an fluoride varnish, OR noted in EHR/other record as completed outside of the medical home. 30% 40% 50% 60%

20 Data - Healthy Smiles 2020 Challenge Reporting Baseline: 1/1/2017 through 12/31/ submit during registration process Bi-annual and annual roll up data submissions Data Date Frames Submission Date 1/1 6/29 7/31 Annual Roll Up (1/1 12/31) 2/15 Data Submission: (Self Report) A. Total Patients in Denominator B. Patients in Denominator by age category Total # children 6-12 months Total # children months Total # children months Total # children months C. Patients in Numerator by age category Children 6-12 months Children months Children months Children months

21 Recognition Program Travel to fromthefirsttooth.org/challenge to learn more and register!

22 Need CME for BOLIM requirements? With the support of the Board of Licensure in Medicine and our statewide partners, QC released six Online Learning Modules August 1, 2017, on SAFE OPIOID PRESCRIBING that offer CME credit. Compliance with Maine Prescribing Laws Safe Opioid Prescribing & Prescribing Limits Chronic Pain Management Appropriate Diagnosis and Treatment of Opioid Addiction Safe & Compassionate Tapering Snuggle ME Guidelines: Improving Maternity & Newborn Care with Substance Exposure During Pregnancy

23 Upcoming Dates Upcoming Child Health Webinars: March 8, 2018, 12-1 PM Collaborative and Proactive Solutions for Children with Challenging Behavior: Lives in the Balance with Ross Greene, MD Tuesday, March 13, 2018, 12-1 PM, "Snuggle ME Guidelines, What's New?" with Kelley Bowden REGISTER NOW Tuesday, June 12, 2018, 12-1 PM, "Integrated Care for Pregnant & Parenting Women with Opioid Use Disorders" with Daisy Goodman - REGISTER NOW Future ME CHIP Meeting Dates (2 nd Friday, every other month by zoom: No meeting in April 2018 due to CALM Learning Session on 4/13 June 8, 2018 August 10, 2018 October 12, 2018 December 14, 2018

24 Contact Information Amy Belisle, MD, Director of Child Health Quality Improvement, Maine Quality Counts, , x1002 Kayla Cole, QC for Kids Child Health Program Manager, Jackie Tiner, QC for Kids Administrative Coordinator, , 1036 QC for Kids Website:

Mission. Maine Quality Counts is a member driven nonprofit located in Manchester, Maine.

Mission. Maine Quality Counts is a member driven nonprofit located in Manchester, Maine. Mission Maine Quality Counts is a member driven nonprofit located in Manchester, Maine. We are working to improve the health of all Maine people (and beyond) by transforming the way healthcare is delivered.